Incidence Of End-Stage Renal Failure Amongst Long-term Survival Of Primary Liver Transplant Recipients Under Tacrolimus: Adults and Children

87 Results of liver transplant (Ltx) have improved considerably in last decade due to better surgical technique, improve perioperative management and development of newer immunosuppressive agents. Renal impairment in all Ltx recipients has remained a major problem mainly due to drug toxicity. Its true incidence leading to end stage renal disease following successful Ltx in long term is not known. Aim of the present study is to examine the incidence of end stage renal disease among the Ltx recipients who have survived beyond five years following primary Ltx under tacrolimus.Material and Method: One thousand patients (834 adults; age>18 yr. and 166 children; age<18 yr.) underwent primary Ltx under tacrolimus between August 1989 and December 1992 (population has been previously described: Trans. proc. 1995: 27 (1): 1099-1104). As of December 1997, 662patients are actually alive for five to eight years after Ltx. There are 141 children and 521 adults. Number of patients currently on dialysis or received kidney transplant (Ktx) were considered as end stage renal failure.Results: Out of 521 surviving adult Ltx recipients, 18 (3.5%) received Ktx and 11 (2.1%). are on dialysis. The overall incidence of end stage renal disease in adults is 5.1%. Out of 141 children who are currently alive, 2 (1.4%) went into end stage renal disease, 1 received Ktx and another 1 is on dialysis. Thus, the overall incidence of end stage renal disease in Ltx recipients who have survived beyond five years is 4.7 _%. Their mean age, sex, and survival from Ltx is shown in the table below.Summary and conclusions: Prevalence of end stage renal disease is 4.7% following successful survival of beyond five years in primary Ltx recipients under tacrolimus.1.8% of the patients are on dialysis while 2.9% patients underwent Ktx. The rate of end stage renal failure in children is 1.4% compared to 5.6% in adult population.